The charge nurse also provides information to physicians within the organization. A centralized structure has few sources of information and communication in its hierarchical system. The charge nurse has been mandated to provide information for physicians as well as clinical nurses (Yoder-Wise & Patricia, 2010).
In a centralized structure, most decisions are made by the hospital chief executive or the head of the nursing home. The hospital has a hierarchical model of administration, and every worker has a clear definition of his/her duties and responsibilities. Information flow in the hospital follows a top-bottom structure, that is, from the top executive down to the clinical nurses (Marquis & Huston, 2006). One manager or head nurse can be in charge of different departments. Staff nurses are not included in major decision-making processes or the implementation process. It takes centralized structures a long period of time to respond to emergency activities due to high bureaucracy levels in the hospital. In a decentralized structure, decisions are made at different organizational levels. Hospital workers are consulted before major decisions affecting their departments are made, and they are involved in the implementation process. Departmental managers are responsible for decisions within their department, and every department has a separate head. Low bureaucracy levels facilitate quick response to emergency activities. Within the organization, informal communication networks exist, which facilitate information flow and decision-making (Porter-OGrady & Malloch, 2012).
Nurses in a decentralized organization are involved in decision-making processes, and this increases their job responsibilities, leading to job satisfaction. This improves staff nurses’ moral responsibilities and decision-making capabilities. Decentralization empowers staff nurses and physicians to formulate their unit level work plans, policies, and procedures. Middle level hospital ...
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Conversely, in a decentralized structure, the organization has spread responsibilities across various departments, and lower level managers are in charge of decisions regarding their department. In this case, clinical nurses had to communicate their problems to charge nurses and the nurse manager frequently contacted the director of nursing.
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